Provider Demographics
NPI:1699658112
Name:ROUSEFF, REBECCA (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:ROUSEFF
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4004 LISBON PL
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-2920
Mailing Address - Country:US
Mailing Address - Phone:305-849-2545
Mailing Address - Fax:
Practice Address - Street 1:4540 BEE RIDGE RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-2567
Practice Address - Country:US
Practice Address - Phone:941-413-0417
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-30
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA16059235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist